National network helping skilled immigrant health care professionals practise in Canada

Leah Geller
July 27, 2022

The underutilization of skilled immigrants is costing Canada more than $11 billion a year and nowhere is this more striking than in Canada’s health care sector. Despite a crippling shortage of health care workers across the country, skilled newcomer doctors and nurses continue to face enormous barriers to practicing their profession here.

So this June, the Government of Canada announced $1.5 million to help internationally educated health care professionals fill some of those critical positions in Canada’s health care labour market. The funding will go to the National Newcomer Navigation Network (N4), based out of the Children’s Hospital of Eastern Ontario (CHEO) in Ottawa.

Since 2019, N4 has been working to assist newcomers navigate the complex Canadian health care system. They’ll now use the connections, tools and resources they’ve built over the last six years to address the barriers that prevent newcomer health care workers, such as doctors and nurses, from practising their profession in Canada.

Christine Kouri is the Manager of Health Equity & Diversity at CHEO. She first developed the N4 program in response to the influx of Syrian refugees into Ottawa, with $4.8 million over three years from Immigration, Refugees and Citizenship Canada’s (IRCC) Service Delivery Improvements fund.

“We saw 300 Syrian children in early 2016 with very complex needs and we had to respond quickly and effectively. We knew that the best way to do that was to connect with people already working on these kinds of challenges across Canada and across sectors,” Kouri said in an interview with Research Money.

“So we created the N4 platform, where everyone could share their innovations and break down geographic and disciplinary silos. We also built upon the Ottawa model of Community of Practice working groups by Dr. [Michael] Fung-Kee-Fung, to put the best minds together in the same room to identify gaps and brainstorm solutions.”

Aware of the success of the N4 initiative, IRCC asked if Kouri’s team could also address the problem of underemployment of newcomer health professionals in Canada. While the issue had existed for decades, the loss of health care workers during the pandemic created a new sense of urgency.

N4 had already built relationships with key health care organizations, such as the Canadian Medical Association, the Canadian Nurses Association, the Public Health Agency of Canada and Healthcare Excellence Canada.

Kouri’s team is now extending the network to include organizations that play a direct role in credentialing and licensing of newcomer health care professionals, such as the Canadian Residency Matching Services and the National Nursing Assessment Program. The network also includes universities, settlement agencies and those with lived experience as newcomer health professionals.

“One of our strengths is this wide network of close to 1,000 members and umbrella organizations across Canada who can work together to solve this problem,” Kouri said. “We aim to meet all of them either in person or virtually to understand them as stakeholders. These are real partnerships we’ve developed.”

International health professionals face several barriers

Sahar Zohni is the Project Manager for N4, including the Internationally Educated Healthcare Professionals (IEHP) program and brings firsthand experience of the barriers faced by newcomer health professionals. Despite more than 20 years practising as a pediatrician in Egypt and the U.K., she was unable to practise in Canada.

“The first barrier international health professionals face is that the pathway to getting licensed in Canada is not clear at all,” Zohni says. “The rules differ across provinces and are changing all the time. Once you do figure it out, it’s a very expensive process that takes an extremely long time. And even if you jump through all the hoops, getting residency, which is required for licensing, is really difficult as there are few residency spots for newcomer physicians.”

To address the fragmented set of rules along the pathway to practising, N4’s IEHP program is creating Canada’s very first one-stop shop with all the information a newcomer health professional might need. It includes daily RSS feeds with the latest updates on credentialing, licensing, residency and recruitment for international physicians and nurses.

“Another barrier is the language assessment, which expires every two years and has to be repeated while you’re busy writing your qualifying exams and getting work experience” Zohni noted.

“And while in theory some provinces offer practice-ready assessments as a route to licensure for international physicians, the reality is these opportunities are not promoted and there are not enough assessors to go around. And then there is the issue of unconscious bias at the employer end.”

In response, the N4 IEHP program is offering an online course with their partner, St. Paul University’s Institute for Transformative Leadership, that fosters integration of newcomer health professionals within the Canadian cultural context.

The N4 IEHP program is also leveraging their network to map out the journey of a newcomer health professional from pre-arrival to practise, which has never been done before. The goal is to identify the specific barriers newcomer health professionals face on that journey and provide concrete solutions for each of those barriers.

“Ultimately, we want newcomer health professionals to be optimally employed,” Kouri said. “The impact of not doing this is huge – for Canada’s health care system and for the individuals themselves. Sadly, Canada is known for having taxi drivers who are physicians or engineers. They end up giving up and directing any hope for real Canadian employment towards their children.

According to Zohni, “To become a doctor or nurse takes years and years of investment by a country. We’re letting that investment by other countries go to waste. This doesn’t make any economic sense. And we talk about mental health all the time, but look at the toll this is taking on our best and brightest newcomers. Canada is failing them.”

“My hope is that there are major changes to the system by next year,” Zohni added. “I believe all the players can work together to make sure newcomer health professionals can more fully contribute their skills to Canada’s health care system.”


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